Registration

Registration for Summer 2021

* Indicates required field

Parents Name: *

Parents Name (2): *

Address *

Parents Cell *

Parents Cell (2) *

Parents Email *

Parents Email (2) *

Swimmer's Name *

First

Last

Gender *

Male Female

Swimmer's DOB *

Age 6/1/21 *

Swimmer's Name *

First

Last

Gender *

Male Female

Swimmer's DOB *

Age 6/1/21 *

Swimmer's Name *

First

Last

Gender *

Male Female

Swimmer's DOB *

Age 6/1/21 *

Medical Release Information:

Primary Medical Insurance Name: *

Policy Number: *

Preferred Hospital: *

Known Allergies or Other Pertinent Medical Information: *

By submitting this form, I give my permission for my child to participate in the Trojan Aquatic Club. I will not hold the aquatic club, York Suburban School District or the coaching staff responsible for any injury while participating in the program. I also give permission for my child to be treated by emergency personnel in the event of an injury if I am not present.

Submit

Swimmer Registration

$225.00

Please add each swimmer as an item to your cart.

Add to Cart